PRISM, a Novel Visual Metaphor Measuring Personally Salient Appraisals, Attitudes and Decision-Making: Qualitative Evidence Synthesis

Abstract

BackgroundPRISM (the Pictorial Representation of Illness and Self Measure) is a novel, simple visual instrument. Its utility was initially discovered serendipitously, but has been validated as a quantitative measure of suffering. Recently, new applications for different purposes, even in non-health settings, have encouraged further exploration of how PRISM works, and how it might be applied. This review will summarise the results to date from applications of PRISM and propose a generic conceptualisation of how PRISM works which is consistent with all these applications.MethodsA systematic review, in the form of a qualitative evidence synthesis, was carried out of all available published data on PRISM.ResultsFifty-two publications were identified, with a total of 8254 participants. Facilitated by simple instructions, PRISM has been used with patient groups in a variety of settings and cultures. As a measure of suffering, PRISM has, with few exceptions, behaved as expected according to Eric Cassell’s seminal conceptualisation of suffering. PRISM has also been used to assess beliefs about or attitudes to stressful working conditions, interpersonal relations, alcohol consumption, and suicide, amongst others.DiscussionThis review supports PRISM behaving as a visual metaphor of the relationship of objects (eg ‘my illness’) to a subject (eg ‘myself’) in a defined context (eg ‘my life at the moment’). As a visual metaphor, it is quick to complete and yields personally salient information. PRISM is likely to have wide applications in assessing beliefs, attitudes, and decision-making, because of its properties, and because it yields both quantitative and qualitative data. In medicine, it can serve as a generic patient-reported outcome measure. It can serve as a tool for representational guidance, can be applied to developing strategies visually, and is likely to have applications in coaching, psychological assessment and therapeutic interventions.

To what extent do disease severity and illness perceptions explain depression, anxiety and quality of life in hidradenitis suppurativa?

“…Studies could also build on the results of this study and examine coping mechanisms and resilience in patients with HS along with how they might affect health outcomes, which has been touched upon previously . Finally, it will be interesting to see whether the results are replicated when employing dynamic HS scoring systems such as the International Hidradenitis Suppurativa Severity Score System, and how illness perceptions relate to other validated and skin‐specific subjective measures of disease burden such as PRISM (Pictorial Representation of Illness and Self Measure) …”

Pictorial Representation of Illness and Self Measure (PRISM): A Novel Visual Instrument to Quantify Suffering in Liver Cirrhosis Patients and Liver Transplant Recipients

“…The strengths of the PRISM method have already been discussed in detail elsewhere [ 2 ]. In summary, the method is easy to use, quickly understood, and provides immediate results.…”

“…The PRISM is a visual task that can be performed by patients in a few minutes using a magnetic board or a tablet computer and can therefore be easily incorporated into clinical routines. This innovative tool has been used to quantitatively measure illness-related suffering in various populations [ 2 , 7 – 11 ].…”

Transplantation experience as a predictor for quality of life during the first 6 months after lung transplantation

“…The PRISM was implemented as a measure for the processing of an illness . Prism consists of an A4‐sized metal plate on which the relationship of the patient's self to various life areas can be represented with different‐colored discs (“icons”).…”

“…Thus, the present study aims at providing a benchmark for the systematic study of psychological factors in the transplantation process. To measure the conscious as well as the subconscious processing, we chose a multimethodical approach including the usage of a standardized questionnaire, verbal interviews, and a pictorial instrument for the prereflexive visualization of experiences ( Prism ) . We were particularly interested in the following questions: How does the patients’ QoL develop in the first 6 months after lung transplantation?…”